Baclofen, a GABA-B receptor agonist, is FDA approved to reduce spasticity associated with neurological disorders. In 2014, it was given a temporary recommendation in France for treating alcohol dependence. A recent meta-analysis on outcome data from 13 RCTs (total N=1492)17 showed that baclofen was associated with a significantly greater time to first lapse to drinking [SMD=0.42 (95% CI=0.19–0.64)], a greater likelihood of abstinence during treatment [odds ratio=1.93 (95% CI=1.17–3.17)], and a non-significantly greater percentage of days abstinent [SMD=0.21 (95% CI= −0.24 to 0.66)] than placebo. There was also a significant difference based on dosage, with studies of ≤60 mg/day of baclofen showing an association of the drug with a longer time to a first lapse in drinking [SMD=0.57 (95% CI=0.30– 0.84)], while those that used >60 mg/day did not [SMD=0.12 (95% CI= −0.07 to 0.28).17 Finally, a significant correlation was observed between abstinence and mean daily alcohol use at study intake, with higher daily alcohol use at baseline associated with a larger baclofen treatment effect.17 In summary, baclofen appears to delay a return to drinking and help sustain abstinence, particularly in individuals who at baseline drink very heavily, with no added benefit of a dosage >60 mg/day.
